Context: Viscoelastic hemostatic assays (VHA) are commonly used to identify specific cellular and humoral causes for bleeding in cardiac surgery patients. Cardiopulmonary bypass (CPB) alterations to coagulation are observable on VHA. Citrated VHA can approximate fresh whole blood VHA when kaolin is used as the activator in healthy volunteers. Some have suggested that noncitrated blood is more optimal than citrated blood for point-of-care analysis in some populations.
Aims: To determine if storage of blood samples in citrate after CPB alters kaolin activated VHA results.
Settings And Design: This was a prospective observational cohort study at a single tertiary care teaching hospital.
Methods And Material: Blood samples were subjected to VHA immediately after collection and compared to samples drawn at the same time and stored in citrate for 30, 90, and 150 min prior to kaolin activated VHA both before and after CPB.
Statistical Analysis Used: VHA results were compared using paired T-tests and Bland-Altman analysis.
Results: Maximum clot strength and time to clot initiation were not considerably different before or after CPB using paired T-tests or Bland-Altman Analysis.
Conclusions: Citrated samples appear to be a clinically reliable substitute for fresh samples for maximum clot strength and time to VHA clot initiation after CPB. Concerns about the role of citrate in altering the validity of the VHA samples in the cardiac surgery population seem unfounded.
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9732968 | PMC |
| http://dx.doi.org/10.4103/aca.aca_34_21 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Electronic Health Record Time Allocation Among Primary Care Clinicians at the Veterans Health Administration Using Virtual Observations.
J Gen Intern Med
January 2025
VA Puget Sound Health Care System, Seattle, WA, USA.
Background: Prior research has shown that primary care clinicians (PCPs) spend a large portion of clinic visits on tasks within the electronic health record (EHR). However, no time allocation studies have been done in the Veterans Health Administration (VHA) and little is known about EHR time spent during virtual visits.
Objective: To estimate the proportion of clinician time spent working within the EHR during primary care visits at VHA clinics.
Veterans May Be Seeing Lower-Quality Clinicians In The VHA Community Care Network.
Health Aff (Millwood)
January 2025
Thomas C. Tsai Harvard University and Brigham and Women's Hospital.
With the rapid expansion of veterans' access to community care under the Veterans Affairs Maintaining Internal Systems and Strengthening Integrated Outside Networks (VA MISSION) Act of 2018, ensuring that veterans receive high-quality community care has become a national priority. Using Veterans Health Administration (VHA) data and Medicare performance scores, we assessed how clinicians' performance on quality measures differed between those who treated veterans within the VHA Community Care Network and those who did not. We found that in 2022, 66.
View Article and Find Full Text PDFOutpatient dermatology appointment wait times for United States military veterans, 2014-2021.
Arch Dermatol Res
January 2025
Department of Dermatology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA.
Trends in outpatient dermatology appointment wait times for United States (US) veterans are poorly characterized. Given concerns surrounding prolonged wait times at Veterans Health Administration (VHA) medical facilities, the federal government introduced the Maintaining Internal Systems and Strengthening Outside Networks (MISSION) Act in 2018, allowing veterans to receive VHA-reimbursed community care if VHA specialty care appointments cannot be scheduled within 28 days. Considering this expanded access to community care, we characterized among US veterans the (1) overall demand for dermatology appointments, (2) trends in average wait times, and (3) facility/geographic variation in wait times.
View Article and Find Full Text PDFMental Health Treatment among U.S. Military Veterans: Insights from the National Health Interview Survey.
J Gen Intern Med
January 2025
Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, USA.
Background: In the United States (U.S.), the prevalence of anxiety and depression is increasing, yet significant barriers to mental health treatment remain.
View Article and Find Full Text PDFChronic Pain Treatment Utilization in Rural Versus Urban/Suburban Inhabitants Following Traumatic Brain Injury.
J Head Trauma Rehabil
January 2025
Author Affiliations: Department of Rehabilitation Medicine, University of Washington, Seattle, Washington (Drs Bale and Hoffman); and Craig Hospital Research Department, Englewood, Colorado (Mr Sevigny).
Objective: To determine whether there are differences in healthcare utilization for chronic pain based on location (rural vs urban/suburban) or healthcare system (civilians vs Military Service Members and Veterans [SMVs]) after moderate-severe TBI.
Setting: Eighteen Traumatic Brain Injury Model Systems (TBIMS) Centers.
Participants: A total of 1,741 TBIMS participants 1 to 30 years post-injury reporting chronic pain at their most recent follow-up interview.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!